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Biomedical subjects

K Verma

Publications and source records attributed to K Verma.

At least 19 recordsLinked to original sources

Medullary carcinoma of the thyroid: a cytological, immunocytochemical, and ultrastructural study.

The cytomorphological features of 38 cases of medullary carcinoma of the thyroid on FNAC were studied. These cases were retrieved from the files of the cytopathology laboratory. In addition, staining for calcitonin (19 cases), thyroglobulin (5 cases), neurone specific enolase (7 cases), and carcinoembryonic antigen (8 cases) was done. Electron microscopy was done in two cases. On morphology, the presence of amyloid together with cytoplasmic granules was found to be diagnostic. The plasmacytoid cell type and the mixed cell populations were most commonly observed. Pseudononuclear inclusions were seen in 58% of cases. Calcitonin was present in 74% of cases. NSE was noncontributory, whereas CEA was positive in one of the calcitonin negative cases.

Biopsy, Needle

Pulmonary function and immunologic abnormalities in miliary tuberculosis.

In a group of 33 patients with miliary tuberculosis (MTB), pulmonary function testing and bronchoalveolar lavage (BAL) were each performed in 31. The arterial blood gas analysis was done in 13 patients. Mild restrictive ventilatory defect, hypoxemia, and hypocapnia were observed. BAL revealed lymphocytic alveolitis. The lymphocyte subsets were measured in the BAL fluid and peripheral blood in 10 patients. The helper lymphocytes were decreased in the peripheral blood and increased in the BAL fluid. The immunoglobulins (IgG, IgA, and IgM) were significantly increased in the peripheral blood and BAL fluid in 18 patients. Serum complement (C3) (n = 23) and BAL fluid fibronectin (n = 22) were also significantly increased. Lymphocytic alveolitis and the raised levels of IgG and IgA in the peripheral blood and BAL fluid persisted at the end of 9 months of standard chemotherapy for tuberculosis. Long-term studies with larger numbers of patients are required to monitor the course of alveolitis in MTB. An addition of corticosteroids to the antituberculosis drug regimen may be considered in the treatment of these patients.

Adult

Detection of human papilloma virus types 16 & 18 DNA in cervical lesions of Indian women using in situ hybridization.

Fifty one biopsies from women with malignant lesions of the uterine cervix and 9 biopsies fron non-malignant lesions were examined for the presence of HPV 16 and 18 DNA sequences by in situ hybridization method using 35S-labelled DNA probes. HPV 16 DNA sequences were detected in 82.4 per cent biopsies from women with malignant lesions, whereas HPV 18 DNA was detected in only 3 biopsies which were also positive for HPV 16 DNA. Two biopsies from non-malignant lesions were positive for HPV 16 DNA only. Data were also analysed according to the histologic type of cancer. It was observed that no significant correlation existed between HPV types and different histologic types of cervical cancer.

DNA Probes, HPV

The prognostic significance of ploidy analysis in operable breast cancer.

The nuclear DNA content of 98 operable breast cancers was determined by flow cytometric analysis using paraffin-embedded tissue. All patients were on follow-up and failure of treatment or recurrences were identified. DNA ploidy data in the form of ploidy status and DNA index (DI) has been correlated with various clinical and histopathologic factors. The only significant correlation using univariate analysis exists between the histologic grade and DI (P less than 0.025), recurrence of the disease and ploidy status (P less than 0.005), and recurrence of the disease and DI (P less than 0.005). The absence of correlation of ploidy status with other tumor derived factors indicates the independent nature of ploidy as a prognostic factor. Multivariate analysis showed that in the whole-group ploidy (P less than 0.01), tumor margin (P less than 0.01), and menopausal status (P less than 0.01) were significant factors in the order mentioned. DI with a cut of at 1.29 is not found to be a significant factor in the multivariate analysis. The maximum prognostic value of ploidy status was observed in the postmenopausal group (P less than 0.0005). In the node-negative group ploidy status (P less than 0.05) is the only independent significant factor predicting for early relapse. It is concluded that ploidy status is an independent prognostic factor predicting for recurrence of the disease. In the node-negative subgroup this could be used to identify the subset of patients who may benefit from adjuvant treatment.

Breast Neoplasms

Extracranial metastasis of an astrocytoma detected by fine-needle aspiration: a case report.

Extracranial metastasis of gliomas is rare, and the documented cases of extracranial metastasis are based on histological material. A case of metastatic astrocytoma to the soft tissue of the neck and back detected by fine-needle aspiration is reported. Demonstration of glial fibrillary acidic protein by immunoperoxidase technique on aspirated material helped to confirm the diagnosis.

Adolescent

Percutaneous ultrasound-guided fetal skin biopsy: a new approach.

Our preliminary experience with this unreported percutaneous ultrasound guided method using a fine needle system showed 100% success (seven cases) in obtaining fetal skin biopsies. The fetal scalp was chosen for biopsy. This technique is easy, less invasive, simple, has minimum procedural difficulties and complications and thus it may replace fetoscopy for obtaining fetal skin biopsy.

Biopsy, Needle

Cytomorphology of metastatic melanoma--use of S-100 protein in the diagnosis of amelanotic melanoma.

The cytomorphological features of cells from 52 cases of metastatic melanoma obtained by fine needle aspiration cytodiagnosis were studied. Morphologically, 11, 19 and 22 cases were classified as spindle, epithelial, and mixed cell types of metastatic melanoma respectively. There were 34 melanotic and 18 amelanotic melanomas. Besides melanin, the presence of intranuclear cytoplasmic inclusions, eosinophilic macronucleoli and giant cells were helpful in the diagnosis of a melanoma. Where attempted, staining for S-100 protein was positive in all the 19 cases (eight amelanotic and 11 sparsely pigmented melanomas). In addition eight cases of metastatic tumour where a differential diagnosis of poorly differentiated carcinoma or large cell lymphoma was entertained, were also studied for localization of S-100 protein and all were found to be negative. Electron microscopy was performed in five cases and showed the presence of melanosomes and/or premelanosomes.

Biopsy, Needle

Effect of prednisolone treatment in chronic silicosis.

We evaluated the effects of daily oral prednisolone therapy on alveolitis parameters and pulmonary function tests over a 6-month period in patients with chronic silicosis. Pulmonary function tests were done in 34 patients, and bronchoalveolar lavage (BAL) was done in 21 of them. Pulmonary function tests showed a significant improvement in lung volumes, FEV1, PEFR, SGaw, DLCO, and PaO2. Analysis of BAL fluid revealed a significant decrease in total cell count. Mean fibronectin and immunoglobulin values in BAL fluid also were lower after treatment, but the change was not statistically significant. No serious side effects were encountered with prednisolone therapy. These results indicate that daily oral prednisolone therapy may suppress the alveolitis in certain patients with chronic silicosis and bring about a significant improvement in lung functions and gas exchange.

Adult

Laparoscopic & histological features of hepatocellular carcinoma.

Laparoscopic findings in 17 patients of proven hepatocellular carcinoma are reported. The laparoscopic appearance was of two types viz., solitary mass (in 12) and a multinodular lesion (in 5). Five patients with a solitary lesion involving the right lobe of the liver had associated satellite lesions. There was no evidence of cirrhosis in 8 (47%) patients. Ascites, peritoneal metastasis and splenomegaly were observed in 24, 12 and 17 per cent patients respectively. The commonest histological pattern seen was trabecular (65%) followed by anaplastic (17%), acinar (12%) and fibrolamellar (6%).

Aged

Diagnostic accuracy of immediate interpretation of fine needle aspirates.

A total of 197 fine needle aspirates (FNA) from various body sites was subjected to immediate interpretation to determine its diagnostic accuracy. For the entire series, the immediate interpretation revealed a sensitivity of 97 per cent, specificity of 96 per cent, a positive predictive value (PV) of 92 per cent, a negative predictive value of 98 per cent and an efficiency of the test of 96 per cent. The false positive rate was 1.5 per cent and false negative rate 0.5 per cent. The diagnostic accuracy of immediate interpretation was comparable for aspirates from different sites. Our results indicate that immediate interpretation of FNA is ideal for determining the adequacy of material and providing a rapid basic diagnosis. This technique could offer useful substitute to frozen sections particularly when facilities for the latter are not available.

Biopsy, Needle

Aspiration cytology diagnosis of echinococcosis.

We report five cases of echinococcosis diagnosed on material obtained by fine-needle aspiration. The sites were the liver in three cases, the thigh in one case, and the retroperitoneum in one case. No complications were observed.

Adolescent

Elevated blood glucose is associated with poor outcome in the carbon-monoxide-poisoned rat.

Levine-prepared, unanesthetized rats exposed to 2400 and 2700 ppm carbon monoxide (CO) for 90 min were used to examine the effect of acute CO poisoning on plasma glucose and insulin concentrations, and neurologic dysfunction. Body temperature and mean arterial blood pressure fell progressively during CO exposure. Glucose rose during initial CO exposure, then declined: glucose increased again after 2 h of room air recovery. Neurologic deficit, behaviorally-assessed after 4 h of recovery, was strongly correlated (r = 0.71, P less than 0.001) with glucose increase during the first 2 h of recovery. Recovery hyperglycemia was, in turn, correlated (r = 0.69, P less than 0.001) with the fall in glucose during the second half of CO exposure. Neurologic deficit was also correlated, but less strongly so, with hypoglycemia during CO exposure. Failure to rapidly regain body temperature during recovery was correlated with the post-CO rise in glucose concentration and with increased neurologic deficit. Plasma insulin activity was depressed immediately following CO exposure, and increased during recovery. CO-induced hypothermia was greater at 2700 than at 2400 ppm CO, as were post-CO recovery hyperglycemia, neurologic deficit and mortality, while body temperature recovery was less complete. The results provide evidence of an association between neurologic deficit and general morbidity following acute CO poisoning and the magnitude of post-CO hyperglycemia.

Animals

Value of enumerating cellular constituents of bronchoalveolar lavage fluid in differentiating sarcoidosis and cryptogenic fibrosing alveolitis.

Based on the observations of cellular constituents in the BAL fluid in 73 patients with sarcoidosis and 18 patients with cryptogenic fibrosing alveolitis, various diagnostic criteria for differentiating these two disorders were examined. Receiver operator characteristics curve was constructed using different levels of lymphocyte percent (L) in the BAL fluid. Discriminant accuracy was improved if the percent of polymorphs (P) was also taken into account. A log transformation of the ratio L/P + 1 was normally distributed and most useful in differentiating sarcoidosis from cryptogenic fibrosing alveolitis. A formal analysis of results may be helpful in assigning likelihood ratios for the observations on cellular constituents of BAL in patients suspected to have sarcoidosis.

Adult

Effect of pea and lentil lectins on in vitro absorption of nutrients.

In vitro absorption of nutrients like glucose, leucine, protein hydrolysate and Ca2+ by ligated loops of small intestine was significantly affected in presence of lectins from peas and lentils. Except for sucrose, all other nutrients showed significant decrease in their absorption in presence of lectins. Lentil lectins had a greater inhibitory effect than pea lectins.

Animals

Carboxyhemoglobin in the rat: improvements in the spectrophotometric measurement and comparison to other studies.

An improved and simplified spectrophotometric method for the determination of carboxyhemoglobin (COHb) is described, which employs an equation to correct for the dissociation error during analysis. Two microliters, or less, of blood is diluted with an ammonium hydroxide solution directly in the measuring cuvette. A layer of light mineral oil overlying the diluent was found to increase measured COHb saturation of blood equilibrated with 100% CO. Sodium dithionite treatment of the oil further increased this value in one case. The measured COHb was shown to be affected directly by factors that alter hemoglobin concentration in the diluent (i.e. blood volume, hematocrit). Blood samples kept cold and under oil may be stored safely for as long as 10 days. Measurement of COHb by this method in rats exposed to 525, 900, 1800 and 2400 ppm CO produces higher values than those obtained with the 1965 spectrophotometric method of Commins and Lawther. Variations on the method of Commins and Lawther, as well as COHb values available in the literature for animals exposed to CO, are reviewed briefly.

Animals

Cardiovascular, metabolic and neurologic effects of acute carbon monoxide poisoning in the rat.

Acute severe carbon monoxide poisoning was investigated in a modified Levine preparation. The rats inhaled 2700 p.p.m. CO for 90 min (COHb = 80%). Body temperature, heart rate and carotid systemic and 'stump' blood pressure declined sharply during CO exposure. By 2 and 4 h post-CO, body temperature and blood pressure had not renormalized, while heart rate was elevated. Blood glucose was unchanged at termination of CO exposure, but increased from 115 mg/dl to 191 mg/dl by 2 h post-CO. Hematocrit increased significantly during CO exposure, but no change in plasma volume was observed. Many rats showed one-sided muscle weakness and unidirectional rotation. By 4 h post-CO, behaviorally-assessed neurologic deficit was strongly correlated with an increase in left cerebral hemisphere water content, demonstrating a direct relationship between brain edema and dysfunction resulting from CO poisoning.

Acute Disease

Noninvasive evaluation of left ventricular function in chronic severe anemia.

Left ventricular function was evaluated noninvasively in cases of chronic severe anemia (CSA) by recording systolic and diastolic time intervals (STI and DTI). These time intervals were recorded in 38 patients with CSA (hemoglobin below 7 g%), without cardiac decompensation, and in 30 control subjects. STI and DTI were measured from the simultaneous recordings of the apexcardiogram, carotid arterial pulse, electrocardiogram and phonocardiogram. The left ventricular ejection time was significantly prolonged (p less than 0.02), and associated with marked shortening of the PEP and reduction of the PEP/LVET ratio (p less than 0.001 in each case) in cases of CSA as compared to controls. Regarding the DTI, there was significant shortening of total filling time, slow filling time (p less than 0.001 in each case) and atrial systole (p less than 0.01) with no appreciable change in rapid filling time and isovolumic relaxation time. The SFT/RFT ratio and a/H ratio (the amplitude of the a-wave relative to the total height of the apexcardiogram) showed significant reductions (p less than 0.001 in each case). These changes in STI and DTI indicate enhanced left ventricular performance during diastole followed by faster and more complete relaxation during diastole in CSA.

Adult